This invention relates to a process for tunneling through subcutaneous tissue to place catheters or similar sized devices in a patient as for chemotherapy, antibiotic administration, and similar uses and to a device for aiding in such process.
Tunneling of a variety of catheters for antibioses and/or patient comfort for permanent or semi-permanent catheters has been performed for decades. In the past this has been done by adapting various surgical instruments in order to create the tunnel. In general, techniques for developing new tunnels have involved the use of large trocar devices of varying sharpness that are most uncomfortable for the awake patient. Further, manipulating the large, cumbersome devices are technically difficult and increase risk for wound and catheter contamination.
A technique for replacement of Hickman catheters was reported by Romas and Lindens (Surgery, Gynecology & Obstetrics, Vol 164, May 1987) and works well for its particular purpose. It could not be used for closed-end catheters or any catheters in which the proximal length cannot be trimmed. It essentially uses a previously developed tunnel rather than creating a new one. References describing somewhat related techniques appear in the appendix at the end of the specification.
None of the techniques and devices described in the references known to applicant are as satisfactory for creating new tunnels for containing catheters, etc., as that described below.